Report: Pa. hospitals in need of psychiatric care beds

Pennsylvania’s hospitals are rated second overall in the nation for access to emergency care and third for quality and patient safety environment in emergency departments, but they are in need of psychiatric care beds, according to a report released Thursday by the American College of Emergency Physicians.

Dr. Charles Barbera, president of the Pennsylvania chapter of the American College of Emergency Physicians, said Pennsylvania’s high ranking for access to emergency care reflects dedication and hard work on the part of the state’s policymakers and medical work force, but the state has had decreases in the number of emergency departments, staffed inpatient beds and psychiatric care beds since 2009.

“These losses have led to increased crowding in Pennsylvania’s emergency departments, which is detrimental to patients,” said Barbera in a prepared statement.

The bed shortage contributed to the state’s rank for disaster preparedness dropping from fourth place in the nation with an “A” in 2009, to 17th place with a “C-Plus.” The report recommends that Pennsylvania health officials adopt a statewide psychiatric bed registry to help cope with the decrease.

Advertisement

Pennsylvania Medical Society President Bruce A. MacLeod said in a press release on Thursday that addressing the “boarding” of psychiatric patients in emergency rooms was voted on as a high public health priority by medical society members last fall.

“It’s not unusual for a psychiatric patient to spend hours in the emergency room while staff members try to track down an available bed. A statewide registry would be quite useful and expedite care for these patients,” said MacLeod, who is a practicing emergency physician from Pittsburgh.

In Delaware County, both Mercy Fitzgerald Hospital in Darby and Crozer-Chester Medical Center in Upland have crisis centers designed to accommodate patients with psychiatric issues.

About 240 people each month visit the crisis center at Mercy Fitzgerald, which has a 21-bed, inpatient behavioral health unit with an average daily volume of 17 patients, said Kathryn Conallen, chief executive officer and senior vice president of acute care services for Mercy Health System. She said that includes patients who have been medically cleared and transferred from the emergency department, walk-in patients and patients from other hospitals that do not have crisis centers.

“Our focus is on continuing to work with local officials at the county level and community organizations to ensure patients have access to the most appropriate level of care to meet their mental health status,” said Conallen.

About 3,500 patients per year are seen at the crisis center at Crozer-Chester Medical Center that has a 32-bed adult unit and a 12-bed child and adolescent unit, said Grant Gegwich, spokesman for Crozer-Keystone Health System, which includes Delaware County Memorial Hospital in Upper Darby, Springfield Hospital, Taylor Hospital in Ridley Park and Community Hospital in Chester.

“To ensure that psychiatric issues do not tie people up unnecessarily in emergency departments or inpatient units, Crozer-Keystone offers consultation services at all of the hospitals within our health system,” said Gegwich.

In other areas evaluated by the American College of Emergency Physicians in its “America’s Emergency Care Environment: A State-by-State Report Card — 2014,” Pennsylvania earned an “F” for medical liability, in part, because it lacks additional protections for life-saving care mandated by the Emergency Medical Treatment and Active Labor Act. Physicians and hospitals could end-up assuming $1.3 billion in unfunded liability left by the phase-out of MCARE, Pennsylvania’s liability insurance program, according to the report.

Because of high infant mortality rates and unintentional poisoning deaths, Pennsylvania earned a “C-Minus” for public health and injury prevention, according to the report. It also noted above-average rates of smoking among adults, which indicates a need to strengthen smoking bans in restaurants and bars.

Members of the American College of Emergency Physicians, based in Dallas, Texas, applied 136 measures in five categories to evaluate conditions under which emergency care is being delivered in the U.S.

They said conditions surrounding emergency care overall this year in the United States earned a near-failing grade of “D-Plus” as compared to “C-Minus” in 2009. Pennsylvania overall was sixth in the nation this year with a “C-Plus” for emergency care environment.

About the Author

Patti Mengers is a reporter for the Daily Times who writes health and religion issues. She's also a member of the paper's editorial board. Reach the author at pmengers@delcotimes.com
.